[acb-hsp] Sexual Addiction Panic!

[peter altschul]

Sex Addiction Panic! The Conservative, Religious Push to 
Pathalogize Sexuality
  Tracy Clark-Flory, Salon November 29, 2011
  The Newsweek cover model's bare shoulders and protruding 
clavicles seem to signal weakness, vulnerability, illness.  She's 
captured turning away from the camera and a pull-quote is stamped 
across her head: "I lost two marriages and a job.  I ended up 
homeless.  I was totally out of control." The all-caps headline 
dramatically spells out her troubles: "THE SEX ADDICTION 
EPIDEMIC."
  The sexy alarmism of Newsweek's latest cover story is 
irresistible -- but it should be viewed with extreme skepticism.  
Mental health experts haven't come to the consensus that sex 
addiction even exists, let alone that it's an epidemic.  The 
cultural phenomenon of sex addiction, which I first wrote about 
in 2009, is just that: A cultural phenomenon, not a legitimate 
medical diagnosis, and the release this week of the much 
buzzed-about "Shame," a sex-addiction drama starring Michael 
Fassbender, further secures the conceptbs place in the zeitgeist.  
Never mind that it was rejected from the upcoming revision of the 
Diagnostic and Statistical Manual of Mental Disorders (DSM), 
psychiatry's bible.
  Supporters of the sex-addiction paradigm will point to the 
current umbrella category of "Sexual Disorder Not Otherwise 
Specified," which recognizes "distress about a pattern of 
repeated sexual relationships involving a succession of lovers" 
-- but the term "sex addiction" is unscientifically applied to a 
vastly greater range of behaviors, including subjectively 
excessive masturbation and porn-viewing.  An entry on 
"hypersexual disorder" is being considered for the DSM revision 
-- for the appendix -- but it's important to note that the 
concept of sex addiction is but one approach to conceptualizing 
and treating hypersexuality.
  In the interest of countering the Newsweek narrative, I gave 
clinical psychologist David Ley a call.  I figured he might have 
a thing or two to say on the topic, given that for the past year 
he's been working on the upcoming book "The Myth of Sex 
Addiction" b and did he ever.
  Have you had a chance to read the Newsweek cover story?
  I did.  It's the same old story.
  And what is the same old story, exactly?
  There's a gross over-representation and exaggeration of 
research.  The sex-addiction concept is a belief system, not a 
diagnosis; it's not a medically supported concept.  The science 
is abysmal.
  What's the worst example of the pseudo-science?
  The thing that drives me craziest is that over the past year or 
two, [proponents of the sex addiction model] have started trying 
to use brain science to explain it.  They're now talking about 
morphological changes that supposedly happen in the brain as 
somebody watches porn or has too much sex.  The reality is, 
careful scientists will tell you they are absolutely unable to 
identify any brain differences between these alleged sex addicts 
and non-sex addicts.  The other thing that they'll tell you is 
that the brain changes constantly -- any behavior that a person 
engages in, especially repetitively, changes your brain.  So, 
identifying changes related to this sexual behavior and 
distinguishing it from anything else is absolutely ridiculous.
  What they're doing is trying to build credibility.  The major 
way that they build credibility is through metaphor, or 
"valley-girl science," as I call it.  They will tell you, and 
[the Newsweek] article is a good example of it, that sex 
addiction is stlst an eating disorder, it's like a heroin 
addiction.  The reality is this is an incredibly weak form of 
argument, because it's so subjective; and when they tell you that 
sex addiction is like an eating disorder, they don't tell you all 
the things that are different about it.  They live by anecdotes, 
because they don't have good science.
  It seems the question underlying the whole conversation is: 
What does a healthy relationship to sex look like?
  They are typically unable to put forth a healthy model of 
sexuality, and when they do, it is so transparently conservative 
and religiously driven that it's frightening.  Most of the 
leaders of the sex-addiction movement are themselves recovering 
supposed sex addicts and religious folks.  That's fine, it's fine 
for them to be advocating, but what they're advocating for is a 
moral system, not a medical one.
  For a while, they were pushing the idea that if you had an 
orgasm once a day, every day, that made you a sex addict -- but 
they finally had to back off on that because data was building up 
showing that there are lots of people who have sex once a day and 
have no problems.  That's the other big hole in their argument: 
For every one of the behaviors they raise as addictive -- whether 
it's porn, strip clubs, masturbation, infidelity, going to 
prostitutes -- I can present 10,000 people who engage in the 
exact same behavior and have no problems, and they can't explain 
why that is.
  They are trying to connect a lot of disparate behaviors.  
Frankly, I think that it is ludicrous to try to apply one 
sex-addiction concept to the behavior of a person who spends 12 
hours a day masturbating and that of a person who has three or 
four mistresses.
  How shd' we look at someone who spends their entire day 
masturbating?
  A lot of the research that has been done shows that between 70 
and 100 percent of these alleged sex addicts have some other 
major mental-health problem -- there is some other diagnosis, 
whether it is substance abuse, depression, anxiety or a 
personality disorder.  It violates Occam's razor to then throw in 
a sex-addiction diagnosis when these behaviors are just symptoms 
of the underlying mental illness.
  The other thing is, why are we singling out this one behavior 
as a problem? There are people who do model trains obsessively: 
They focus their life on it, their relationships end because of 
their interest in this, they fill their houses with these model 
trains-
  But we aren't rushing to subject them to brain scans.
  Exactly, right.  This is a moral attack on sexuality.  it is in 
the interest of people to build and develop fear of sex.  Because 
they think that if we're not afraid of sex, people are going to 
go out and have lots of sex.  God forbid.
  What cultural forces are bringing this to the fore right now?
  I think it's a perfect storm.  It's the media and the 
transparency of our society.  All of these behaviors have been 
happening for millennium -- people cheating, people having lots 
of sex, people viewing pornography.  There's nothing new about 
this.  But all of a sudden we have this 24/7 media that is hungry 
for scandals.  "Gotcha" journalism grabs an audience by putting 
out a sound bite, a meme, as quickly as possible, regardless of 
how true it is.  The memes that grab the most are 
black-and-white, two-dimensional concepts.  Rather than 
explaining that there are thousands of reasons a person might 
engage in infidelity, it's easier to say: Sex addict.
  Does it make people feel more secure, like the threat of 
infidelity is contained to a "disordered" or "addicted" 
population? Blaming infidelity on sex addiction might be easier 
than questioning monogamy or our expectations for long-term 
commitments.
  Yep.  Instead of examining the application of the concept of 
monogamy over a 30- or 40-year marriage, and looking at how male 
sexuality works, it's much easier to say: "Well, it's a disease." 
I include a quote in my book where a woman says, "When my husband 
was cheating, it really was a comfort to consider it a disease 
and that it really wasn't his fault.  Finally, I had to realize 
that it wasn't a disease, it was just him being selfish and 
treating my life and health casually." If we look at it as a 
choice, what changes?
  What is the risk of the spread of the sex-addiction model?
  There is a dramatic risk of stigma and over-diagnosis.  Gay and 
bi men often engage in significant promiscuity that is outside 
the norm for heterosexual men, and certainly for heterosexual 
women -- are they eligible to get diagnosed as sex addicts? Yeah.  
A social worker I talked to at a mental hospital told me that 
whenever an LGBT person was admitted onto the psych ward, they 
automatically considered them as having hypersexual disorder, 
because they were concerned that person might act out sexually on 
the unit.
  There's incredible risk of pathology here -- we only need to 
look at the history of nymphomania to see that.  Women had their 
clitorises removed they were subjected to electroshock therapy, 
all kinds of medication.  When female sexuality was diagnosed as 
a disease.  Now male sexuality is diagnosed as a disease, only 
instead of getting electroshock therapy they get the country-club 
treatment for 30 days.
  Tracy Clark-Flory is a staff writer at Salon.
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